White matter lesion subtypes and cognitive deficits in patients with memory impairment.
OBJECTIVE
To analyze the relationship between periventricular (PV) and subcortical (SC) white matter lesions (WML) and cognitive function in patients with memory impairment.


METHODS
In total, 253 patients with Global Deterioration Scale scores >or=3 who had been referred to a university-based memory unit due to memory complaints were included (mean age 69.7 years, 124 females). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) and the Neurobehavioral Cognitive Status Examination (Cognistat), and full test results were available for 217 patients. PV and SC WML loads (semi-quantitative rating on axial T(2)-weighted MRI scans) were used in linear regression as predictors of cognition.


RESULTS
MMSE was significantly correlated with SC WML (p = 0.005), but not with PV WML (p = 0.19). Cognistat tests for orientation, comprehension, visuoconstruction, calculation, similarities, and judgment were negatively correlated with SC WML (p < 0.01), as was verbal memory with parieto-occipital SC WML (p < 0.05). Visuoconstruction and calculation were negatively correlated with PV WML (p < 0.05). Parieto-occipital WML were more strongly related to cognition than fronto-temporal WML. Only SC WML were significantly correlated with cognition when PV and SC WML were entered simultaneously in the regression model.


CONCLUSIONS
In patients with cognitive impairment, SC WML, in particular in parieto-occipital regions, were associated with reduced cognitive function.
Stenset
Vidar
V
Department of Neurology, Akershus University Hospital, Lørenskog, Norway. vidar.stenset@medisin.uio.no
Hofoss
Dag
D
Berstad
Audun Elnaes
AE
Negaard
Anne
A
Gjerstad
Leif
L
Fladby
Tormod
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000235:genetics / Q000473:pathology* / Q000523:psychology*; D004493:Education; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000235:genetics / Q000473:pathology* / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests
D001057:Apolipoproteins E